Synergistic platelet inhibition between Omega-3 and acetylsalicylic acid dose titration; an observational study

BMC Complement Med Ther. 2020 Jul 2;20(1):204. doi: 10.1186/s12906-020-02990-9.

Abstract

Background: Omega-3 and acetylsalicylic acid (ASA) are two widely used "over-the-counter" drugs. Previous research has shown multiple electrode aggregometry (MEA) can detect ASA and varying Omega-3 platelet inhibiting effects. Synergistic platelet inhibiting effects of ASA and Omega-3 have been found using other methods than MEA. The aim of this study was to investigate the antiplatelet effects of Omega-3, and ASA synergism with MEA.

Methods: Ten healthy male volunteers ingested Omega-3 (1260 mg/day) for 5 days. MEA was used to analyse platelet function before and after Omega-3 intake. Aggregation was initiated using three different agonists and measured as area under the curve (AUC): adenosine diphosphate (ADP), thrombin receptor activating peptide (TRAP) and arachidonic acid (ASPI). Two concentrations of ASA were dose titrated ex vivo to 2 out of 3 ASPI test cells in order to measure synergism between Omega-3 and ASA.

Results: Following 5 days Omega-3 intake, ADP, TRAP and ASPI AUC did not change significantly. In vitro ASA before Omega-3 intake, reduced ASPI AUC < 30 U, indicating a strong platelet inhibiting effect. Below this AUC level, the 5 days Omega-3 intake increased ASPI-AUC with the ex vivo added low dose ASA (P = 0.02) and high dose ASA (P = 0.04).

Conclusions: No synergism between ASA and Omega-3 was found using the MEA ASPI test. The surprising increase in ASPI-AUC following Omega-3 intake and ex vivo ASA suggest that there are methodological issuses with the MEA ASPI test.

Trial registration: Trial registration ISRCTN78027929 . Registered 19 May 2015.

Keywords: Acetylsalicylic acid; Coagulation; Omega-3.

Publication types

  • Observational Study

MeSH terms

  • Adenosine Diphosphate / metabolism
  • Adult
  • Arachidonic Acid / metabolism
  • Aspirin / administration & dosage
  • Aspirin / pharmacology*
  • Drug Synergism
  • Drug Therapy, Combination
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / pharmacology*
  • Humans
  • Male
  • Peptide Fragments / metabolism
  • Platelet Aggregation / drug effects*
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / pharmacology*
  • Young Adult

Substances

  • Fatty Acids, Omega-3
  • Peptide Fragments
  • Platelet Aggregation Inhibitors
  • thrombin receptor peptide SFLLRNP
  • Arachidonic Acid
  • Adenosine Diphosphate
  • Aspirin